Stress-Induced Chest Pain
Stress and panic attacks can cause chest pain and are typically a sign that you’re doing something far outside your comfort zone. Panic attack symptoms include:
- Chest pain often described as sharp or tight that lasts only a few minutes
- Difficulty breathing
- Dizziness
- Elevated heart rate
- Nausea
- Nervousness
- Shakiness
- Sweating
- Weakness
It’s important to manage stress levels because chronic stress can set in motion changes in your body that can increase your risk of a heart attack. When stressed, your body produces cortisol, which has been linked to high blood pressure, weight gain and obesity—all risk factors for coronary artery disease and heart attack. Additionally, some people may cope with stress in unhealthy ways, such as smoking, overindulging in alcohol or overeating, which increases the risk for heart disease.
Healthy ways of coping with stress include:
- Deep breathing
- Exercising
- Sleeping eight hours a night
- Practicing mindful meditation or other relaxation techniques
Sharp Chest Pain
When chest pain is sharp, the cause may or may not be heart attack related. Sharp chest pain is typically caused by conditions other than a heart attack, including:
- Aortic dissection (a tear in the aorta, the main artery that moves blood from the heart to other areas of the body)
- Gastrointestinal causes like acid reflux
- Costochondritis (inflammation of the cartilage around the ribs)
- Muscle pain
- Broken rib
- Panic attacks
- Pericarditis (infection in the sac around the heart)
- Pulmonary embolism (blood clot in the lung)
- Pneumonia with pleurisy (painful inflammation in the linings of the lungs)
What is Angina?
Angina is chest pain due to heart disease. Stable angina refers to chest pain or other heart attack symptoms that resolve with rest. It typically occurs during certain levels of physical exertion or emotional stress. Angina is another way your body is saying rest, relax and take some deep breaths.
If you have a history of stable angina, you should follow up with your cardiologist if your episodes of angina are becoming more frequent or unpredictable. New, worsening or persistent symptoms warrant an emergency evaluation and could indicate your condition has progressed to unstable angina.
Unstable angina refers to chest pain or other heart attack symptoms in a person with coronary artery disease (CAD) that is more unpredictable. This can be a warning sign that heart disease is worsening.
What is coronary artery disease (CAD)?
When you have CAD, cholesterol builds up on your arterial walls, forming plaque over time. This narrows the passageway for oxygenated blood to reach your heart.
Eventually, this narrowing greatly reduces blood flow or blocks the vessel entirely, causing a heart attack.
Prior to progressing to the point of causing a heart attack, CAD can cause chest pain and other symptoms similar to those of a heart attack.
Heart Attack Symptoms
The most immediately life-threatening cause of chest pain is a heart attack. The blocked coronary artery stops or greatly reduces blood flow to your heart causing heart muscle damage. Symptoms include:
- Chest pain following emotional stress
- Chest pain after exercise or other physical exertion
- Chest pain below the breastbone that can feel like pressure, tightness, fullness, squeezing or burning
- Cold, clammy sweat
- Difficulty breathing
- Jaw pain
- Neck pain
- Pain between the shoulder blades
- Pain in the lower chest or upper abdomen
- Shoulder or arm pain, numbness or tingling
- Sudden nausea or vomiting
Heart attack symptoms can present differently in different people. If you’re a woman, you’re more prone to have symptoms like pain between the shoulders, in the neck or in the jaw, sometimes without chest pain.
Treatments for Heart Attack and CAD
If you have CAD or a heart attack, your doctor will evaluate you to determine the appropriate treatment, which may include medication, angioplasty or cardiac surgery to restore blood flow to normal levels. Afterward, he or she may:
- Instruct you to stop smoking if you smoke
- Prescribe medications like statins to help lower your low-density lipoprotein (LDL, or bad) cholesterol levels and raise your high-density lipoprotein (HDL) cholesterol levels
- Prescribe daily cardiovascular exercise
- Prescribe a heart-healthy diet of nutrient-dense, fibrous foods that are low in fat and sugar
- Recommend you reduce stress
How to Prevent a Heart Attack
If your heart is telling you to take it easy to avoid a heart attack, there are many things that you can do to reduce your risk of having one, including:
- Exercising regularly
- Eating a healthy balanced diet
- Quitting smoking
- Avoiding drinking alcohol in excess
- Getting routine checkups to monitor and ensure optimal management of heart disease risk factors, such as diabetes, high blood pressure and high cholesterol
- Managing your stress in a healthy manner
